- Sutter Health (Roseville, CA)
- …case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Awareness of ... management , quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers… more
- Sutter Health (Burlingame, CA)
- …case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of ... management , quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers… more
- Sutter Health (Jackson, CA)
- …Health! **Organization:** SAH-Sutter Amador Hospital **Position Overview:** Coordinates the utilization management , resource management , discharge planning, ... management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Working knowledge… more
- Cedars-Sinai (Los Angeles, CA)
- …in the inpatient and/or ambulatory setting. + Works with Inpatient Case Management and Inpatient Nursing to support and coordinate hospital discharge by working ... services provided through the value-based program such as Ambulatory Care Management . Follows and coordinates care of patients enrolled in value-based programs… more
- Sutter Health (San Francisco, CA)
- …Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute care patient experience. The ... case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Some awareness… more
- Evolent (Sacramento, CA)
- …quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… more
- VNA Health (Santa Barbara, CA)
- …in clinical education, inservice and nursing staff meetings. + Participate in Quality Management and Utilization Review Activities. + Maintain necessary ... Differentials + Schedule: 3 days/week, 12 hours/day Job Description: The Inpatient Registered Nurse provides hospice care and is skilled at assessing pain and other… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …system and treatment methods, with specific knowledge and skills in areas of risk management , infection control, and utilization review . + Current knowledge ... and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Clinical Nurse Educator PAY RANGE: $135,200-$170,690 Annually REPORTS TO: Chief Nursing… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Health Educator** supporting **Naval Medical Center San Diego, CA ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Evolent (Sacramento, CA)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management … more